Aktif akciğer tüberkülozu olgularda bronkoskopik yöntemlerin tanıya katkısı

Abstract

Aim: The aim of this study is to evaluate the sensitivity of bronchoscopic sampling methods for detection of acid-fast bacilli (AFB) in patients with suspected active pulmonary tuberculosis with no sputum production. Methods: The study evaluated the data of patients who had bronchoscopy for suspected pulmonary tuberculosis at our department between 2000 and 2006. Eighty-three patients with positive bacteriology for tuberculosis in bronchoscopic lavage, bronchoalveolar lavage or post-bronchoscopic sputum were selected as study group. Results: The total number of bronchoscopic examinations at our department between 2000 and 2006 was found as 4548 and the specimen of 1297 (29%) of these patients were investigated for tuberculosis. The specimens of 83 patients (%6.4) were positive for AFB in smear or culture. The smear for AFB was found positive in bronchoscopic lavage of 43 (52%), bronchoalveolar lavage of 7 (29%) and post-bronchoscopic sputum of 12 (39%) patients with tuberculosis. The culture for M. tuberculosis was found positive in bronchoscopic lavage of 72 (88%), bronchoalveolar lavage of 18 (64%) and post-bronchoscopic sputum of 28 (90%) patients. No significant difference was found between three methods for detection of tuberculosis. Conclusion: As the accuracy of bronchoscopic procedures is low, the induced sputum should be evaluated before bronchoscopy and the bronchoscopic examination must cover bronchoalveolar lavage and postbronchoscopic sputum